Why are so many people going to see a GP rather than their dentist when they have problems with their teeth?

About 600,000 people a year in the UK who develop dental problems now visit a GP rather than going to a dentist, the British Dental Association revealed last week. That is roughly 11,000 people a week. The BDA, which represents dentists and dental students, blames the rising cost of dental treatment. It sees charges for dental treatment as “a tax on health”. It is also worried that such cases are adding to the growing pressures on already overstretched doctors and costing the NHS an estimated £26m.

In the last dental health survey, 26% of adults said the cost involved had been a factor in choosing the type of dental treatment they received, while 19% said they had delayed having treatment for the same reason.

Is this a new problem, perhaps caused by the NHS-wide financial squeeze?

In addition, 96% of GPs want more to be done to discourage patients with dental problems seeking their help, Comres found.

Can GPs do anything to help?

Not really. People come with tooth pain, abscesses and other ailments. However, “GPs are neither trained nor equipped to deal with these problems, particularly those that require an operative intervention. GPs can offer pain relief or antibiotics, but will usually refer patients to a dentist”, says Henrik Overgaard-Nielsen, chair of the BDA’s general dental practice. “The overwhelming majority of these patients require root treatment or extraction, which GPs cannot provide. GPs can treat symptoms, not causes. Painkillers and antibiotics are never a solution to dental problems.”

For example, a patient with an abscess will often need the infection to be drained or the tooth taken out; GPs can do neither procedure.

Dr Maureen Baker, chair of the Royal College of GPs, agrees. “GPs are not dentists. Patients who are experiencing pain or discomfort with their teeth and/or gums should seek an appointment with their local dentist, not their family doctor. GPs are in no position, and shouldn’t be put in a position, to treat patients with dental problems,” she says.

The BDA is worried that dental charges in England went up by 5% in April and are set to rise by another 5% next year. It claims the increases are designed to force patients to make up for diminishing amounts of government funding for dentistry – down £170m in England since 2010-11, from £2.2bn to £2.03bn.

Charges in England are much higher than in the rest of the UK. It costs £19.70 for an examination there, but only £13.50 in Wales, while such checks start at £6.68 in Northern Ireland and are free in Scotland. However, that £19.70 also includes diagnosis and X-rays or a scale and polish, if you need that.

One leading dentist refutes that this is too costly. “Twenty pounds for an appointment to sort out toothache? You need to decide where this sits in affordability.” But charges can go up quickly if you need fillings, root canal treatment or tooth removal (£53.90) or crowns, dentures or bridges (£233.70).

Many patients on low to moderate incomes get no exemption from dental charges.

How much do dentists earn?

Dentists’ average gross earnings in England and Wales were £155,100 a year in 2013-14. But that figure has been falling in recent years. After deducting their expenses, such as running their premises and buying equipment and supplies, their taxable income is about half that impressive-sounding sum – £74,400 a year. “I’m not saying we don’t make a reasonable living. But it’s no more than the average professional would be making,” the senior dentist says.

Would the nation’s teeth be in better shape if all dentistry was NHS-funded?

Dentists complain that NHS dentistry is a “Cinderella service”, its low status confirmed by the gradual scaling-back of government funding. Maintaining charges that deter at least some people on lower incomes is “feeding a false economy”, says Overgaard-Nielsen. “It’s cheaper for dentists to keep healthy teeth in healthy mouths than for GPs to offer pain relief or for hospital surgeons to perform extractions under general anaesthetic.”